Comparative Pharmacology
Head-to-head clinical analysis: IONSYS versus RYZOLT.
Peer-Reviewed Evidence
Head-to-head clinical analysis: IONSYS versus RYZOLT.
IONSYS vs RYZOLT
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
IONSYS is an iontophoretic delivery system for fentanyl, a mu-opioid receptor agonist. Fentanyl binds to mu-opioid receptors in the CNS, inhibiting ascending pain pathways and altering pain perception and emotional response.
RYZOLT is a selective serotonin reuptake inhibitor (SSRI) that potentiates serotonergic activity in the CNS by inhibiting the reuptake of serotonin at the presynaptic neuronal membrane, increasing serotonin levels in the synaptic cleft.
Apply one 40 mcg fentanyl iontophoretic transdermal system to skin on upper arm or chest; delivers 40 mcg per dose on-demand for up to 24 hours or 80 doses, whichever is shorter. Maximum 2 doses per hour, 6 doses per application. Patient must be opioid-tolerant.
10 mg orally once daily
None Documented
None Documented
Terminal elimination half-life: 16.3 ± 9.1 hours for fentanyl released from IONSYS; accounts for prolonged release from depot and is longer than intravenous fentanyl (3-12 hours).
Terminal elimination half-life is 12–15 hours in healthy adults; extended to 22–28 hours in patients with severe hepatic impairment.
Renal: approximately 90% as fentanyl metabolites (mainly norfentanyl) and less than 10% as unchanged drug; fecal: less than 10%.
Primarily hepatic metabolism with renal excretion of metabolites; renal elimination of unchanged drug <5%; biliary excretion accounts for ~10% of total clearance.
Category C
Category C
Opioid Analgesic
Opioid Analgesic